The Treatment of the Borderline Patient: Applying Fairbairn's Object Relations Theory in the Clinical Setting

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9780823666447: The Treatment of the Borderline Patient: Applying Fairbairn's Object Relations Theory in the Clinical Setting
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This book describes a practical, accessible, hands-on approach to the psychotherapeutic treatment of the borderline patient. The perspective presented is particularly suited to the clinician who has many such patients to face, but who is intimidated by psychoanalytic theory. The tactics and techniques described are based on two of the most obvious aspects of pathological behavior seen in borderline patients: 1) their massive dependency on parents, or new partners, who frustrate them endlessly, and 2) their refusal to give up hope on these "Bad Objects" despite a history of severe disappointment.
The theoretical model behind this dependency-based analysis of the borderline condition stems from the nearly forgotten work of W.R.D. Fairbairn, whose views have reemerged in the current writings of Kernberg, Masterson, Rinsley, and Gerald Adler. Fairbairn produced the first true Object Relations model in which he replaced the Freudian notion of the primacy of biological/instinctual motivation with a model based on attachment to objects. His first four theoretical papers are carefully reviewed and form the foundation for the methodology presented throughout the book.
The therapeutic techniques described are pragmatic, accessible, and based on the overall perspective that the borderline patient is pursing objects who have a powerful grip over him or her due to the mixture of hope and frustration that activates an internal state of extreme longing. This desperate internal state of longing for an object is a consequence of developmental deprivation and is generated, either unilaterally by the patient, or in other cases by the manipulations and implied promises emitted by the object. The therapeutic strategies that are described are accompanied by extensive examples.
Many of the techniques are targeted for specific borderline defenses, such as splitting, where the patient suddenly shifts from a position of unrealistic hope in their "Exciting Object" to abject despair when the same person is perceived (often only moments later) as a "Rejecting Object." There are also strategies for helping patients reduce their attachment to internalized objects as well as an in-depth discussion on the management of transference, which is conceptualized as the projection of internalized objects and egos into the therapeutic dyad.
Finally, there are techniques that help the therapist maximize his or her "introjectibility," which is designed to replace the patient's reliance on past destructive internalized objects with newly acquired positive internalizations of the therapist. This book can be used alone, as a handbook for the treatment of the borderline, or in conjuction with pre-existing models, many of which owe part of their structure to Fairbairn's original work.

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Celani, David P.
Published by Intl Universities Pr Inc (1993)
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